Peripheral Arterial Disease: What You Need to Know

So you have a cramp in your leg. It's just part of getting older, right? Well, maybe not. Recurrent pain in the legs is one symptom of peripheral arterial disease, or PAD. Up to 12 million people in the United States are living with this circulatory disorder. Knowing the signs, risk factors, and how you can manage PAD can do more than help you avoid a few aches. It could save your life.

What is PAD?
When most people talk about having poor circulation, they're really describing peripheral arterial disease. You might also hear it referred to as peripheral vascular disease or hardening of the arteries. It's a condition in which blood can't flow well because your arteries are blocked. PAD most commonly affects the legs, but it can also disrupt blood flow to your heart, head, arms, kidneys, and stomach.

PAD often begins the same way that most other circulatory problems start. Smoking, diabetes, high cholesterol, and high blood pressure-the same factors that put you at risk for coronary heart disease-can damage the inner walls of your peripheral arteries. Lipids (blood-borne fats) infiltrate the damaged areas of your arteries, causing a buildup of fatty material called plaque. This leads to atherosclerosis in which plaque accumulates, your arteries harden, and the arterial pathways that carry blood become narrower and narrower. As pathways get narrower, blood cannot circulate to various body parts.

Why Worry?
Poor circulation can cause claudication (pain and numbness) in body parts where blood flow is restricted. Thus, arterial blockages may be the source of your leg cramp, and by the time you're feeling pain, your PAD may be very advanced. In fact, you may not start to feel any discomfort until arteries are blocked 60 percent or more.

If you don't start treating PAD at the first signs of trouble, you could see more serious symptoms such as:

  • Increasingly severe pain
  • Areas of the skin that are cooler to the touch (especially legs or feet)
  • Skin discoloration
  • Loss of body hair around the affected areas
  • Sores that don't heal (usually on the toes and feet)

Left untreated, PAD can lead to severe health problems. It increases your risk of coronary heart disease, heart attack, stroke, transient ischemic attack ("mini-stroke"), and renal artery disease (disruption of blood flow to the kidneys). You can also develop gangrene, requiring the amputation of a toe, foot, leg, or arm; that risk is higher if you have diabetes.

Who Gets PAD?
PAD most often affects people who:

  • Smoke
  • Are 50 years or older
  • Are African American
  • Have diabetes
  • Have high blood pressure
  • Have high cholesterol

Even if you don't have any aches and pains, you should consider being screened for PAD if you fall into one or more of these high-risk groups. Many people suffer from "silent PAD," which means they have no pain or other symptoms, but they are still at risk for PAD-related health complications.

What Do I Do for My PAD?
Depending on your overall health and symptoms, you may be able to treat PAD by making lifestyle changes that include quitting smoking, eating a heart-healthy diet, and exercising. It's also important to manage high blood pressure, high cholesterol, and diabetes. Your doctor may prescribe medication to treat these pre-existing conditions or anti-platelet medications to lower your risk of heart attack and stroke. In very advanced cases, your doctor may recommend surgery to help improve blood flow to areas of the body that have poor circulation.

 If PAD has affected your feet, you should practice good foot care to avoid injuries that could lead to infections. This includes keeping feet clean and moisturized, carefully cutting toenails, using foot powder, and having calluses or corns promptly treated by a podiatrist.



Ezekowitz, Michael D., M.D., Ph.D. "Peripheral Vascular Disease." Yale University School of Medicine Heart Book.  Eds. Barry L. Zaret, M.D., et. al. New York: Hearst Books, 1992. Web. December 20, 2011

"Peripheral Arterial Disease." Cleveland Clinic. n.d. Web. May 16, 2012

"What Is Peripheral Arterial Disease?" National Heart, Lung and Blood Institute. n.d. Web. May 16, 2012